In September 2019, there were 1,219,429 Coloradans enrolled in Health First Colorado and 78,143 enrolled in
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Upcoming Events and Helpful Resources
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| Health First Colorado videos for use in waiting rooms and other areas members visit are available for download on our website. |
New to PEAK or Need a Refresher?
The Intro to PEAK and Application Walk-Through recorded webinars are available anytime. For more information and trainings, visit the
PEAK Outreach Initiative website.
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Public Rule Review Opportunities
Anyone interested in a one-on-one discussion with Department staff about upcoming rules is invited to attend the Department's
Public Rule Review Meeting. Information is available on the
Public Rule Review Meetings webpage.
For more information, or to be added to the Medical Services Board email distribution list, please contact
Chris Sykes.
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Employment Opportunities
Applying for state government jobs is easy. Applications are electronic, you will receive updates, and you do not need to answer any written questions until it is determined that you meet the minimum qualifications.
Check out the
website for State of Colorado jobs including the Department of Health Care Policy & Financing jobs.
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Welcome to the October 2019 edition of
At a Glance!
Thank you for your interest!
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| A Message from the Executive Director |
In honor of National Customer Service Week, we are focusing on the fourth pillar of our new Department performance plan this month:
Customer Service - Improve service to members, care providers and partners
Customer service is at the heart of everything we do at the Department. We serve many external and internal customers in our work - from our providers and members to the General Assembly and taxpayers. We have a responsibility to work toward continuous improvement to ensure we are serving all our customers well.
As outlined in our Department performance plan, the primary way we measure and report out on our progress in improving customer service is by looking at our Average Speed of Answer (sometimes called ASA) of telephone calls coming into our Health First Colorado provider service center. We are pleased to report that in the 2018-2019 fiscal year, we answered provider calls in an average of 42 seconds, exceeding our goal of 60 seconds or less.
The entire performance plan, including more detail on the five pillars and how we measure progress is available
on our website
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Thank you for your continued partnership as we continually work toward our goal of improved customer service.
Kim Bimestefer
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| Connect for Health Colorado Open Enrollment Resources |
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Connect for Health Colorado (C4HCO) Open Enrollment begins November 1, 2019, and ends January 15, 2020.
Please send all your C4HCO related requests via email
. This inbox is dedicated to county eligibility workers.
Please remove all C4HCO inboxes from previous Open Enrollments, including the Case Transfer inbox from your email, and use only the
County Partners Inbox
, as the others are now inactive.
Please only send one case per email. We cannot process email requests that have more than one case included.
Free resources are available to you through C4HCO's Online Store. Simply create a login and shop for materials such as posters, brochures, and financial help charts. Materials will be mailed to your office at no cost. This resource is available to you year-round.
Free, in-person help is available from our certified C4HCO enrollment experts located throughout the state. If anyone in the community you serve needs help, you can refer them to one of our experts to ensure they get the right health insurance coverage and financial help. Find assistance in your area.
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Non-Emergency Medical Transportation Vendor Transition
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IntelliRide now manages all Health First Colorado Non-Emergent Medical Transportation (NEMT) services for
Adams,
Arapahoe, B
oulder, B
roomfield, De
nver,
Douglas,
Jefferson, La
rimer and
Weld counties.
IntelliRide can be reached at 1-855-489-4999. If you call, please:
- Listen carefully to phone tree options.
- Wait to call for rides more than a week away. This will lower call volume and help to prioritize members with immediate transportation needs.
- Provide specific details (member name and Health First Colorado ID, date and time of incident, and destination) when registering a complaint.
- Consider scheduling rides using IntelliRide's website.
The Department and IntelliRide are working diligently to make sure members can get to and from appointments without a disruption in services.
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Child Health Plan Plus Dental: No Co-Pays for CHP+ Prenatal and Postpartum Members
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Dental services are now available for pregnant Child Health Plan Plus (CHP+) members, during pregnancy and for 60 days after delivery.
As with all CHP+ prenatal and postpartum benefits, members will not have co-pays for dental services.
They will benefit from the same services provided for current CHP+ children except for orthodontics (braces). These benefits include:
- Diagnostic services (exams and x-rays)
- Preventive (fluoride, sealants and cleanings)
- Basic restorative services (fillings)
- Endodontic (root canals)
- Emergency dental services
The annual maximum allowable is $1,000 per calendar year (January 1 through December 31) while the member is eligible and enrolled.
Members can contact DentaQuest at 1-888-307-6561, State Relay: 711, or via email through the Member Access Portal.
Providers can contact the DentaQuest Provider Relations Representative in their region for more information:
Northeastern Colorado
303-386-6752
Southeastern Colorado
Central/Metro Denver
720-614-2859
Western Slope
970-210-6395
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Hospital Transformation Program Update
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Hospital Application
A draft of the Hospital Transformation Program (HTP)
hospital application
was posted to the HTP website. The draft application is based on current HTP design, which remains under development. The final application will be updated to reflect any changes to the program design based on collaboration with key stakeholders, members of the Colorado Healthcare Affordability and Sustainability Enterprise (CHASE) Board and negotiations with the Centers for Medicare & Medicaid Services (CMS).
Community Advisory Council
As reported in a September 16, 2019
communication
to hospitals and stakeholders, the Department of Health Care Policy & Financing (the Department) created a Community Advisory Committee with representation from across the state. An update about efforts and discussions can be found on an
informational memo
on the HTP website. The first meeting took place on September 27 in Denver.
Since that communication,
a Community Advisory Council page
has been created on the Department website. While the council meetings will be open to the public, as all Department meetings are, we are not intending to invite a broad group of stakeholders outside of invited council members representing consumers. Meeting agendas, summaries, and other information will continue to be posted on the HTP Community Advisory Council's webpage for those who would like to keep informed about this forum. In addition, we will continue to provide regular updates in our biweekly HTP newsletter.
As we approach submission of the HTP to our federal oversight partner, CMS, we will be hosting public forums where we will invite all stakeholders. Stay tuned to the HTP Newsletter for information about those public forums.
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Partnerships to Improve Population Health
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Home Care Workers Stakeholder Feedback
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The Department and the Department of Public Health & Environment are seeking input from stakeholders on training for home care workers. This effort is part of Senate Bill 19-238, which requires the Departments to consult with stakeholders "to establish a process for reviewing and enforcing initial and ongoing training requirements" for home care agency employees.
The Departments are hosting five public listening sessions across Colorado. We invite interested individuals to attend these meetings in person. Information about the meetings is on the Department's
webpage.
In addition to the public listening sessions, a Training Advisory Committee has been formed and is meeting regularly to develop recommendations to meet the requirements of this bill. Members of the public are invited to attend or listen-in to these Training Advisory Committee meetings. Dates and times are on the Department's
webpage.
The Departments are also seeking input from home care workers directly and invite all interested workers to participate in one of four in-person or virtual focus groups or
complete a home care worker survey to provide feedback and suggestions.
For more information, send us an email or call 303-866-5086.
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Delivery System Innovation
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| Substance Use Disorder Benefit Update |
Section 1115 Substance Use Disorder (SUD) Waiver Application
The Department finished the final draft of the waiver application for submission to the Centers for Medicare and Medicaid Services (CMS). After the Department submits the waiver application, CMS will review the waiver application and post it for 30 days to receive public comments and input.
SUD Capacity Planning
The Department is mapping SUD treatment capacity across the state according to American Society of Addiction Medicine (ASAM) levels, as well as demand for services. The SUD Capacity Building Workgroup continues to examine the network of SUD treatment providers and analyze capacity for SUD services across Colorado.
The Department will host a statewide series of meetings from December 2019 through February 2020 focusing on the state's SUD treatment capacity, demand for services, as well as strategies to identify and address needs/gaps in service.
The schedule of regional capacity meetings will be posted on our website and distributed electronically to stakeholders soon. For additional information, please visit the Department's SUD website.
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| Single Entry Point Request for Proposals Posted |
The Department has posted a Request for Proposal (RFP), soliciting proposals from organizations interested in performing as a Single Entry Point (SEP) agency.
The geographic regions/districts for which proposals are being solicited in the RFP are:
1. SEP Region/District 1 - Mesa County
2. SEP Region/District 2 - Boulder, Broomfield, Clear Creek, and Gilpin Counties
3. SEP Region/District 3 - Adams, Arapahoe, Denver, Douglas, and Elbert Counties
4. SEP Region/District 4 - El Paso, Park, and Teller Counties
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The Colorado National Provider Identifier Law
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The Colorado National Provider Identifier (NPI) Law, mandated by House Bill (HB) 18-1282, requires newly enrolling and currently enrolled Organization Health Care Providers (not individuals) to obtain and use a unique and separate NPI for each service location and provider type enrolled in the Colorado interChange.
The Colorado NPI Law was presented to the Medical Services Board (MSB) for Final Approval on October 11th, 2019. The rule passed by unanimous vote. This rule will be effective on November 30, 2019.
At this time, providers should not attempt to add the newly obtained NPIs to their enrollment records nor use them on claims. In future communications, the Department will provide a more detailed implementation timeline of the upcoming Provider Web Portal update which will allow providers to add the new NPIs.
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Inpatient Hospital Review Program Updates
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The Inpatient Hospital Review Program (IHRP) has been meeting with inpatient providers bi-weekly. Please see guidance and resources below:
- As a general reminder, be aware that the admit date on a Prior Authorization Request (PAR) has to match the admit date on the claim for it to pay correctly. If a discrepancy is noted, the person who submitted the PAR should go in and update the dates. If there are any claims where the discharge date does not match on the PAR/Claim resulting in a denied claim please email the ICN and PAR# to [email protected], and it will be reviewed for reprocessing. Please note, the clinical documentation on the PAR must support the request for an admit date change.
- For patients who move between Observation and Inpatient, the admit date for the IHRP PAR should be the date the patient moved to Inpatient.
- For newborns, the admit date for the PAR should be the date when the mother is discharged, NOT the date of birth for the baby.
The Department and eQHealth Solutions have been working to add additional guides and training resources to the IHRP webpage, including:
- How to view the status of an IHRP PAR
- How to update the Temp Baby ID
- How to enter a Retrospective Review, including members admitted through the emergency room
- Review ID
- PAR #
- Health First Colorado Member ID
- Screenshots
- Error codes
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The Colorado Department of Health Care Policy & Financing complies with applicable federal and state civil rights laws and does not discriminate on the basis of race, color, ethnic or national origin, ancestry, age, sex, gender, sexual orientation, gender identity and expression, religion, creed, political beliefs, or disability. Learn more about our Nondiscrimination Policy.
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-221-3943 (State Relay: 711).
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-800-221-3943 (State Relay: 711).
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At a Glance
